Individual provider Active NPI

Daisy S Angeles, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1073512752
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301037608 Issued in MI
Practice address
1039 Washington St
Dearborn, MI 48124-2016
Phone
(313) 563-1033
Fax
(313) 563-2930
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301037608 MI Primary

Addresses

Primary practice location

1039 Washington St
Dearborn, MI 48124-2016

Mailing address

1039 Washington St
Dearborn, MI 48124-2016
Phone (313) 563-1033

Other identifiers 1

IdentifierTypeStateIssuer
1361633MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1073512752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 WASHINGTON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242016",
            "telephone_number": "313-563-1033",
            "fax_number": "313-563-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 WASHINGTON ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242016",
            "telephone_number": "313-563-1033",
            "fax_number": "313-563-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "DAISY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301037608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1361633",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.